Holly Bianca Goldberg has been helping pregnant women and their families toward more healthy and comfortable birthing experiences for more than eleven years as a Doula, Childbirth Educator, Prenatal Yoga teacher, T’ai Chi instructor, and founder of “Birthing From Center.”  Holly has co-facilitated numerous workshops with pioneer midwife, Ina May Gaskin, at the Omega Institute and has instructed thousands of students across the U.S.  Holly is the Community Outreach Director of the Central Coast Doula Association and is pursuing her doctorate in Prenatal and Perinatal Psychology at SBGI.   She received her bachelors of arts in 1997 from Naropa University.

The interviewer, Arabella Stewart, is Assistant to the President of SBGI, Dr. Marti Glenn.  Arabella received her B.A. in Psychology from Stanford University and completed one year’s M.A. coursework in Clinical Psychology at California Graduate Institute.  She has been a Buddhist student and practitioner for thirteen years, and has written a book on Buddhist reform that is in its final editing stages.

Arabella: When did you become interested in prenatal and perinatal psychology?

Holly: I formally became interested in pregnancy and birth in 1985.  This was the beginning of my exploration of the mind-body connection between mother and baby during pregnancy.  I was studying T’ai Chi in the Traditional Eastern Arts Program at Naropa Institute and did my senior thesis on the effects of T’ai Chi during pregnancy for mother and baby.  I really explored the mother’s connection with herself, her comfort level with her body, connection with her baby, as well as how these affected outcomes of birth and pregnancy. This definitely was prenatal and perinatal psychology, however I wasn’t calling it that. 

Arabella: And was it the energetic connection that drew your interest – in terms of T’ai Chi?

Holly: The energetics!  The physical connection!  The whole thing!  I have been, and I still am, a devoted T’ai Chi practitioner.  As a young T’ai Chi practitioner, I read a quote by Master Chen Men Ching.  It said, “T’ai Chi teaches you what it means to be human.” I was a devoted student and wanted to really understand the meaning of life. I thought, well, if I really want to know, I should start from the beginning…time in the womb and explore how T’ai Chi, this ancient healing arts affect the unborn baby and mother?

Arabella: How did you find your way to the birthing center in Bali – www.bumisehatbali.org/ – where you served as a volunteer?

Holly: I knew the midwife who founded it.  She actually used to live in Maui, and I was really involved in the Maui birthing community. I knew for a couple of years that she had a fairly holistic approach and an active birthing center in Bali, which needed volunteers. 

Arabella: How is the center achieving its goal of developing and implementing “a community based sustainable family cooperative health care model targeting marginalized communities and families in Bali?”

Holly: That’s a pretty big question. 

Well, first of all, they are really only dealing with the marginalized communities in Bali.  One of the biggest issues there is malnutrition.  So, they do a lot with prenatal vitamins, prenatal dietary instructional support and education.  They do a lot in educating and empowering the woman about what’s going on with her baby in her body, there’s been a huge break in that wisdom! 

In many ways, it’s such an indigenous culture.  They have such a strong connection with their family.  The mother and aunties are all involved and help to raise the children.  However, there’s still a huge lack of information about childbearing.  So, I would say that the birthing center there really focuses on nutrition and education about fertility awareness and the development of the baby.

Arabella: The center listed marvelous intentions on its website: institution of community recycling and other environmental projects, production of a book and other materials on nutrition and prenatal care, writing of a book on Balinese medicinal herbs, creation of a publication on family planning, and provision of an HIV/AIDS Prevention Project.  How are these other projects evolving?

Holly: Well, all the books have been written and they’re available and accessible to the volunteers, donors and patients.  They are primarily bought by people who give donations. They want a piece of what is going on at the clinic. 

There are also beautiful books and DVDs about the tsunami.  The clinic in Bali has a sister clinic in Ache, which was really hit hard.  The Bali clinic has actively contributed to major direct relief with all-encompassing care and prenatal care.  Interestingly, the Ache clinic has had a big baby boom since the Tsunami.  They lost their families and they’ve lost their children and the immediate reaction is to procreate.  They are sowing their seeds of hope in a time of horrid living conditions. 

Arabella: Right!  Life goes on.

Holly: Yeah.

The recycling program is in effect.  There’s a huge issue in Bali with trash.  People just don’t have the awareness that we do about throwing their trash away.  So, there’s a lot of trash in the rivers and streets.  The clinic makes a strong effort, and there are recycling bins in the clinic itself.

Arabella: From those working at the center and from the Balinese people and culture, what were some of the key lessons you learned about prenatal and perinatal care?

Holly: Well, one thing I first realized was that, what we consider our baseline of health care is really a privilege!  You know, going to a prenatal yoga class and having a doula or having a midwife or having a birth plan – or even the availability of reading materials to educate yourself about your options and different effects and benefits of various medical procedures and outcomes….that’s a privilege that they don’t have!  That was a huge awareness for me.

And the hospital systems there are kind of scary; there’s a really high c-section rate – astronomically high – and health insurance is extremely expensive.  The people who came to the clinic didn’t have health insurance; that’s why they were coming to the clinic. However, the clinic couldn’t handle all the births owing to the rules and regulations in Bali.  If there were complications, the clinic was required to transfer women to the hospital, where they wouldn’t be able to afford the care in years!  I mean, the average income for a Balinese family – the ones that would come to the clinic – was $30 per month.  And that was supporting, like, eight to ten people!

On a more positive note, Balinese really integrate early bonding into their daily cultural practices.  For instance, the baby is carried consistently for the first few months.  The mother carries the baby and if, for example, she is taking a bath, someone else would hold the baby.  The father tends to the placenta, which gets a ceremonial burial and is given offerings for months after the birth.  There is deep and active reverence for the spirit of birth.

Arabella: How is the placenta viewed?

Holly: The placenta is viewed as the brother or sister of the baby.  And so they basically see the placenta as a twin during the pregnancy.  The umbilical cord is not cut, even in the hospital, for at least a half an hour after birth to ease the transition from the spirit world into the physical world. Afterwards, the family retains the placenta in a bowl, takes it back to the family compound, wraps it in a ceremonial way and then buries it.  They put a rock over it and a thorny bush to protect it from evil spirits and animals. 

The burial spot of the placenta is the spiritual home of the child.  Any time the baby is having a hard time, or the family is having a hard time, the family members will go to the burial site of the placenta and make offerings.  They do a lot of offering in Bali where they actually take rice and flowers and holy water and they put it in a little woven basket and put it out for the Gods.  The reverence for the mother and baby connection, the family unit, and the placenta is really powerful. 

Arabella: What were some of the things that you learned from the volunteers at the Bali birthing center?

Holly: While I was there, midwives from all over the world came.   Many times a group of eight or so women, from Australia, Europe, Hawaii/United States, and Bali would gather over tea and share tricks of the trade.  As you can imagine, that was really, really special!

It reminded me that there’s one universal way of attending to the mothers, babies, and fathers during childbearing.  Even though everyone had tricks that they were sharing, they all had the same intention: to support a healthy pregnancy, healthy birth, and a healthy, positive perspective for the family. That was beautiful!

Arabella: The universal language.

Holly: Yeah.  The universal language.  Supporting and honoring the passageway of pregnancy! 

Arabella: What was the time frame of your going to Bali in relationship to your studying at SBGI?

Holly: I went during the summer between my first and second year.

Arabella: How were the lessons you learned in Bali fed by, and how did they feed into, your studies at SBGI?

Holly: The study of attachment theory really helped me to understand and appreciate the cultural value on bonding in Bali – how they really revere bonding and the mother-child connection, and the father-child connection. I have a more in-depth understanding of the effects of not having that, as well as the benefits of having that! The combination of being in Bali and being in school helped me put things in perspective. It’s one thing to learn things on a scholarly level, and it’s another thing to get your feet dirty!  The conditions in Bali were dirty.

Arabella: And how has what you learned there fed into this year’s work – how do you feel like it will impact you this year?

Holly: After I came back from Bali, I was really clear that my work is in maternal-fetal-child program development. Perinatal care in Bali is really up against major, major friction from hospital regulations and policies.

Arabella: What are you up against here, in the States?

Holly: Some of the same things.  We have policies all over the world that support systems, not people.  This is obvious when you look at many of our perinatal protocols.  In some ways it is more pronounced in Bali.  In some hospitals in Bali, you see a 90% c-section rate.  That’s outrageous!  But there are reasons for that, malnutrition being one.  Women are so under-resourced in their ability to sustain their lives that pregnancy and giving birth really push them to the edge.

Arabella: But there are some of the same challenges here?

Holly: Yeah.  We have many policies that support our systems rather than the individuals. The reality of me going and volunteering in Bali helped…we established a prenatal exercise program – handouts and resources.  That was great, but it really didn’t do that much in the bigger scheme of what they’re working with. For me to create the positive impact that I envision, then I need to step out of the individual, one-on-one therapeutic environment and get into policy development.  Policy development can really affect a lot of people!

Arabella: What would you like to tell us that you have not yet shared?

Holly: My education provides an amazing opportunity for me to look at how much daily life affects a developing fetus.  My goal is to take this understanding, sensitivity and awareness into program and policy development.  We look at program and policy sustainability through the lens of physical health – but to integrate the emotional and psychological implications of our practices with scientific data, resources, and information – this has the potential to create massive change!  This is where I fit in!  Peace on earth begins with birth!